Services for liver disease in district general hospitals in the UK: a national questionnaire-based survey.

The burden of liver disease in the UK is increasing and much of this is managed in district general hospitals (DGHs). Previous studies of liver services have focused on specialist units. This study assessed the provision of liver services in non-specialist units. A questionnaire-based survey was conducted to assess resources, staffing and clinical management of liver disease. Replies were received from 61 consultant gastroenterologists working in DGHs across the UK. The data show inadequate consultant numbers and limited availability of nurse specialists, hepatobiliary pathologists and radiologists. There is marked variability in the management of hepatitis C, variceal bleeding and hepatorenal syndrome. Liver databases and outcomes are rarely kept. There are significant shortfalls in the provision of liver services across DGHs. This supports the need for managed clinical networks and data collection as proposed in the National Plan for Liver Services.